Utah Behavior Services

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Legal business name

UTAH BEHAVIOR SERVICES

Practice address

5202 Freeway Park Dr
Riverdale, UT 84405-4016

Phone

(801) 255-5131

NPI assigned

Nov 10, 2016

Last updated

Nov 10, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dallas Tueller, BCBA/SSWNPI 1538601224

Title

Co-Owner

Phone

(801) 255-5131

Specialties & licenses 1

Addresses

Tax ID family

Bridgeway Integrated Healthcare Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Bridgeway Integrated Healthcare Services

  • Primary Care Clinic/Center
  • Taylorsville, UT
  • NPI 1396383196
  NPD tax ID
• Bridgeway Integrated Healthcare Services Inc

  • Behavior Analyst
  • Taylorsville, UT
  • NPI 1104119619
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dallas Tueller, BEHAVIOR TECH

  • Behavior Technician
  • Riverdale, UT
  • NPI 1538601224
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478736000000",
    "number": "1457893141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 E 4400 S",
            "address_2": "UNIT A",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033846",
            "telephone_number": "801-255-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 FREEWAY PARK DR",
            "city": "RIVERDALE",
            "state": "UT",
            "postal_code": "844054016",
            "telephone_number": "801-255-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH BEHAVIOR SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-10",
        "last_updated": "2016-11-10",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "DALLAS",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "801-255-5131",
        "authorized_official_credential": "BCBA/SSW"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leticia Soares Tomaz, LCSW
• Corinne Totter
• Dallas Tueller, BEHAVIOR TECH
• Thayne Tynsky, RBT
• Ivy Ulrich
• Utah CVS Pharmacy LLC (CVS Pharmacy #16880)
• Brittany Varney, CMHC
• Wal-Mart Stores, Inc (Vision Center 30-1708)
• Greg Walker
• Walmart Inc.

• Behavior Technician in Riverdale, UT
• Providers in Riverdale, UT by specialty
• Behavior Technician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.